Organization
BHRS
Active
Other names
TRS
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MADELYN SCHLAEPHER PHD (DIRECTOR)
(209) 525-6225
Entity
Organization
Contact information
Practice address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 525-6225
Mailing address
800 SCENIC DR, MODESTO, CA 95350-6131
(209) 525-6225
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
LCS14424
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041C0700X
MEDI-CAL
CA
Enumeration date
10/18/2012
Last updated
10/18/2012
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